老年骨质疏松性椎体压缩性骨折行经皮椎体后凸成形术疗效分析

Percutaneous kyphoplasty in treatment of elderly osteoporotic vertebral compression fractures

目的 探讨经皮椎体后凸成形术（percutaneous kyphoplasty,PKP）治疗老年骨质疏松性椎体压缩性骨折（osteoporotic vertebral compression fractures,OVCF）的临床疗效.方法 2009年10月至2013年10月浙江省宁波市医疗中心李惠利医院收治的122例OVCF老年患者,应用随机数字表法随机分为A、B组,每组61例,A组给予PKP,B组给予经皮椎体成形术（percutaneous vertebroplasty,PVP）.观察2组治疗后疼痛程度、活动能力、椎体压缩率和Cobb角情况;2组患者术后均进行至少6个月的随访,对术后不良反应进行记录和分析.结果 治疗后,2组在VAS评分和活动能力方面均明显改善（P＜0.05）,但2组差异无统计学意义（P＞0.05）;治疗后,2组椎体压缩率和Cobb角较治疗前恢复良好,A组较B组恢复更明显,差异均有统计学意义（P＜0.05）;随访结果显示对照组术后出现并发症11例,并发症发生率为11.89％,观察组发生并发症6例,并发症发生率为9.84％,差异有统计学意义（P＜0.05）.结论 PKP和PVP均能显著止痛,但PKP较PVP椎体恢复和脊柱后凸情况改善效果更佳,同时能够有效降低并发症发生率,值得临床推广应用.

Objective To investigate the clinical efficacy of percutaneous kyphoplasty（PKP） in treatment of elderly osteoporotic vertebral compression fractures（OVCF）.Methods 122 elderly OVCF patients from Oct.2009 to Oct.2013 in Lihuili Hospital of Ningbo Medical Center were selected,and were randomly divided into group A,and group B.There were 61 cases in each group.Group A received percutaneous kyphoplasty（PKP）,and group B were treated with percutaneous vertebroplasty（PVP）.The two groups were observed in terms of pain,activity,vertebral compression rate and Cobb angles after treatment.The two groups were followed up at least for 3 months.The postoperative side effects were recorded and analyzed.Results After the treatment,the two groups significantly improved in VAS score and activity（P ＜ 0.05）,but no significant difference was found between the two groups （P ＞ 0.05）.After the treatment,vertebral compression rate and Cobb angle got better than before in the two groups,but group A recovered more obviously than group B,and the difference had statistical significance （P ＜ 0.05）.The postoperative recurrence rate was 18.03 ％ （11/61） in the observation group and 9.84 ％ （6/61） in the control group,and the difference had statistical significance （P ＜ 0.05）.Conclusion PKP and PVP can significantly relieve pain,but PKP had better effect than PVP in vertebral body and spinal kyphosis improvement,which is worth of clinical application.